MPs have urged the government to consider elections for members of trust and health authority boards.
In a report following an inquiry into Dame Rennie Fritchie's report on NHS appointments, published in March, the Commons select committee on public administration urges the government to 'explore whether a greater democratic element could be introduced'.
It suggests elections could be tried 'on a pilot basis' as part of the government's modernisation programme, 'with the results properly evaluated'.
The report also welcomes ministers' commitment to removing MPs from the selection process, but says the most fundamental way of avoiding accusations of political bias may be to take ministers 'out of the loop' completely.
'We believe there is a case for an independent NHS appointments commission to ensure appointment on merit from among a wide range of people', the report says. But it does not back Dame Rennie's call for councillors to lose the right to nominate candidates, suggesting there should be council representation on health bodies 'as of right' but that other local organisations should also be invited to nominate candidates.
Junior health minister Gisela Stuart told the committee that elections to boards could result in members being reluctant to take wider, regional responsibilities into account.
The NHS Confederation also expressed concerns. But it backed the committee's call for the government to respond to each of Dame Rennie's 28 recommendations. She concluded that 'there are examples where a candidate's political association has been a decisive factor in their early selection' and 'some features of the appointments process have been politicised'.
But Ms Stuart was reluctant to accept this in evidence. The committee also says that much of the evidence taken by Dame Rennie was 'anecdotal' and 'inevitably allows some questioning of her findings'.
Its report further says that in the regions Dame Rennie looked at - Northern and Yorkshire and North West - the Labour Party is particularly strong and 'therefore it would be natural to find a high number of Labour sympathisers on health bodies'.
However, the committee adds that Dame Rennie had 'produced an important and timely report' and although some of the findings were disputed 'that is less important than the need to tackle the issues she has identified.'
Appointments to NHS Bodies: report of the commissioner for public appointments .The Stationery Office.£10.60.